Michelle Lynette Davis, ATC

Individual provider Active NPI Athletic Trainer · American Canyon, CA

NPI 1225420508 · NPPES record last updated Nov 18, 2016

Key facts

NPI
1225420508
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
3000 Newell Dr
American Canyon, CA 94503-1279
Phone
(480) 282-2663
NPI assigned
Feb 24, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

3000 Newell Dr
American Canyon, CA 94503-1279

Mailing address

4912 Summer Grove Cir
Fairfield, CA 94534-3991
Phone (480) 282-2663

Other providers in American Canyon, CA

All providers in American Canyon, CA · Athletic Trainer in California

Sources for this page

Verify at the official NPI Registry.